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Controversy of ECT has been fuelled by patients’ reports that the treatment is painful, dehumanizing and terrifying -Improvements in the administration of ECT have been made Effectiveness of ECT-Proponents of ECT maintain that it is remarkably effective treatment of major depression -Many patients who do not benefit from antidepressantsimprove in response to ECT -Opponents of ECT argue that the available studies are flawed and inconclusive and that ECT is probably no more effective than a placebo -Does seem to be enough favourable evidence that the conservative use of ECT in treating severe mood disorders in patients who have not responded to medication -Relapse rates after ECT are distressingly high – 64% relapsed within 6 months – medium relapse was 8.6 weeks -Relapse rates can be reduced by giving ECT patients antidepressants Risks Associated with ECT-Memory loss, impaired attention, cognitive deficits – common short-term side effects of ECT
-Deficits are mild and usually disappear within a month or two -No objective evidence that ECT causes structural damage to the brain or that it has any lasting negative effects on ability to learn and remember information -In contrast – ECT critics – ECT-induced cognitive deficits are often significant and sometimes permanent– evidence seems to be largely anecdotal -Remains controversial New Brain Stimulation Techniques -Transcranial magnetic stimulation (TMS) – new technique that permits scientists to temporarily enhance or depress activity in a specific area of the brain – magnetic coil mounted on a small paddle is held over specific areas of the head to increase or decrease activity in discrete regions of the cortex -Neuroscientists are experimenting with TSM mostly asa treatment for depression -Treatments discovered to the right and left prefrontal cortex show promise in reducing depressive symptoms -TSM – generally well tolerated, minimal side effects – great deal additional research needed for therapeutic value of TSM -Deep brain stimulation (DBS) – thin electrode surgically implanted in brain and connected to an implanted pulse generator so that various electrical currents can be delivered to brain tissue adjacent to the electrode
-Valuable in treatment of motor disturbances associatedwith Parkinson’s disease, tardive dyskinesia, some serious seizure disorders -Researchers currently exploring whether DBS may have values in the treatment of depression of OCD -Highly invasive procedure requiring brain surgery will never ben a frontline therapy for mental disorders – scientists hope it may be valuable for highly treatment-resistant patients who do not benefit from conventionaltherapies 18.Discuss the merits of blending or combining different approaches to therapy. (pp. 723, 726-727) Current Trends and Issues in Treatment Blending Approaches to Treatment -Some research is intended to compare the effectiveness of competing orientations or to determinewhat therapy works best with what specific type of